Cochlear
Implants:

“My parents really wanted my brother and I to get cochlear implants. They
cared about our opinion. It was our body… We were too young to make that
decision. I regret it. We were eight years old,” said Maria Smith*, a
nineteen-year old classmate of mine. Maria and her brother, David, went to
my high school. Maria is Deaf and her brother, David, is hard of hearing,
although they both got cochlear implants when they were younger. When I
interviewed Maria about her cochlear implant, she expressed a sense of pride
in being Deaf. “There’s nothing wrong being Deaf,” she said, “We embrace it,
but David likes having the implant. It wasn’t
for me” (Smith, 2014). There are
several misconceptions about cochlear implants, and to start, it is evident
that the Deaf community is not all lining up to get one.

In some areas, especially the medical field,
society has developed an ideology that if you are without something most
people have, it should be made available to you, and not only made
available, but even wanted. The medical device that displays this
opportunity for the Deaf and hard of hearing community specifically is the
cochlear implant. The first single channel cochlear implant was introduced
in 1972 as an electronic device that provides a sense of sound to those who
are “profoundly Deaf or severely hard of hearing” (Brown). Misconceptions
exist about cochlear implants that should be clarified to help better
understand the Deaf community and options Deaf or severely hard of hearing
people have.

A commonly-held misconception about cochlear
implants is that they are only successful on a narrow, younger age group due
to the fact that their bodies can still more easily learn and accept new
information, like sounds they would be hearing for the first time. After
all, the earlier in life a person receives the implant, the easier it is for
them adjusting to learning how to hear and speak. While not everyone is
eligible for a cochlear implant, they are not necessarily limited to a
specific age group. Ear, nose, and throat specialist, Doctor Robert C.
O’Reilly, explains “children who are 12 months of age or older with profound
hearing loss in both ears are excellent candidates,” but that cochlear
implants are successful on adults as well (KidsHealth).
As O’Reilly states, the best
candidates happen to be younger, however the eligible age group is not a
narrow one. In fact, more adults than children have received cochlear
implants in the United States. According to the Food and Drug
Administration, “as of December 2012 … In the United States, roughly 58,000
adults and 38,000 children have received [cochlear implants]” (Cochlear).
From this statistic, it is clear that adults who have become Deaf or hard of
hearing later in life, or have always been, also experience successful
cochlear implants, otherwise there would not be such a large number still
receiving them in 2012.

While age is not the deciding factor over
who can get cochlear implants, there are other reasons that can make
patients ineligible. On one hand, children’s hearing may be too good without
the use of hearing aids, meaning they could still hear some sound and speech
but not a lot. Other reasons include that the “reason for hearing loss isn’t
a problem with the cochlea” or “the hearing nerve itself is damaged or
absent” (KidsHealth). The latter reasons are necessary to coincide
with the anatomy of the surgical procedure, and therefore, to get the
desired results. Every potential candidate is evaluated on these
requirements by a cochlear implant team to decide whether an implant should
be used. The cochlear implant team is composed of counselors and doctors.
The counselors evaluate the situation to ensure that the people trying to
get the implant would be suitable for the surgery and have the right
reasoning for getting one. They also conclude if the motivation to
participate in the difficult journey afterward is present in the family. The
doctors, on the other hand, are the ones who look at the reasoning behind
the lack of hearing and their relative compatibility for the procedure (Kids
Health).

Another misconception is that cochlear
implants “fix” Deafness, which is a complete misunderstanding of how they
are designed to work. After receiving a cochlear implant, the patient is
still technically Deaf or hard of hearing. It is not a “cure”. During a
two-four hour surgery, the implant package is placed inside the skull,
within the inner ear. The microphone is worn, and hooked up to the package
on the outside of the ear, which means it can be turned on and off. In
essence, regardless of having received a cochlear implant, the patient is
still considered Deaf for they are still unable to hear sound when the
speech processor is turned off (KidsHealth). Furthermore, even when
the processor is turned on, the patient will not hear sounds like a non-hard
of hearing or Deaf person would. Doctor O’Reilly describes the process of
the conversion of sound as such: “Sound is sent to the sound and speech
processor… analyzes the sound and converts it into an electrical signal” (KidsHealth).
O’Reilly goes on to explain that the electrical signal is decoded in the
implant package, where the electric current determines the sounds’ loudness
and pitch. By transportation of the hearing nerve, the message goes to the
brain, and lastly, the brain interprets the sound (Nevala). In this way,
getting the cochlear implant does not restore normal hearing. The sound
heard is similar to a robotic tone.

As stated previously, it is a mistaken
belief that all Deaf people want a cochlear implant. The results described
above are not necessarily ideal. Not only are the interpreted sounds
electronic-sounding, but for those who have never had the ability to hear
properly, the sounds can be extremely overwhelming (Cochlear).
Unlike natural hearing and speech development, which occurs over a number of
years as a baby, these patients are hit with all of the different sounds of
the world at once. This process is straining because they can hear
everything simultaneously, such as the lights buzzing, refrigerator humming,
pets moving, television, and the dishwasher running all at once. They have
to train themselves to “focus on only a couple sounds, which non-hard of
hearing people have learned to do naturally over time” (Hear).

In the documentary film Hear and Now,
Paul and Sally Taylor, a born-Deaf couple in their 60’s, decided to get
cochlear implants together so that they might hear for the first time in
their lives. Their daughter filmed their reactions as they dealt with this
new, profound experience of sound in their Deaf worlds. Paul adapted well to
the implants, enjoying everything new he was learning about the world and
the sounds that filled it. While her husband excelled with the new device,
Sally had the opposite experience as her husband. She could not grow
accustomed to all of the new sounds that filled her head and she would
constantly have migraines as a result. Due to the stress it caused Sally,
she lost the motivation to improve and most days would no longer attempt to
wear the outer piece of the cochlear implant (Hear). It is these mixed
reactions to the cochlear implants that also play a role in part of the Deaf
community’s skepticism toward cochlear implants.

Perhaps the strongest argument the Deaf
community has against cochlear implants is that they are genuinely proud of
being Deaf and in some cases could not imagine otherwise. This is the case
for many Deaf and hard of hearing people I know. Take Maria Smith, for
example, who I used to play basketball with on our high school team. She
would rarely have her cochlear implant on, even around only hearing
teammates. I asked her specifically about this in the interview to which she
replied, “I didn’t wear it because it didn’t matter that I was Deaf around
you guys... I would have needed Emma [Maria’s interpreter] to interpret and
I don’t like having it on” (Smith). Having the cochlear implant on just
wasn’t worth it for Maria, and as stated previously, she regrets getting the
procedure. I also questioned her about why she regrets having the procedure
done if she can turn the device off and still be Deaf, while she still has
the option of hearing if she so chooses. “My other Deaf friends don’t judge
me for having it ... I love our Deaf ‘family’ I have and I’m not embarrassed
being Deaf. Why do I have an implant to correct my hearing if I am fine
without it?” (Smith). Simply because Maria is without something most people
have, does not mean she wants it. Following this thought process, it would
be easy to find the pain endured, time spent learning and tuning out sounds,
and the cost of the surgery not worth it if the patient is content with
their life in the Deaf community to begin with. Furthermore, my American
Sign Language 1 teacher in high school, Mr. Johnson*, was an older Deaf man
who expressed a similar mentality as Maria. While Maria claims it just was
not for her, Johnson adamantly believed any hard of hearing or Deaf person
was admitting to having a disability by getting a cochlear implant, while it
was actually a gift to be Deaf. Not every Deaf or hard of hearing person is
against cochlear implants personally or widely like Maria Smith and Mr.
Johnson, but they are ones who prove the idea that all Deaf people want to
hear is far from the truth.

Misconceptions about who is eligible for
cochlear implants, the results from the procedure, and the overall Deaf and
hard of hearing perspective of them are common. Clearing up these false
beliefs could give people the opportunity of receiving a cochlear implant
and hearing for the first time, rather than thinking they were too old for
such a procedure and following experiences. Learning about the variety of
results from getting the cochlear implant could make or break someone’s
decision in getting one so it is important to understand these different
results. It is also important to discredit common misconceptions in order to
better understand, accept, and build relationship with the Deaf community.

*
Some names in this article were changed to protect the privacy of the
individuals.

Jennifer
Enright

November 5, 2004

Cochlear
Implants

(Why culturally
Deaf people are against them.)

I. What Deaf people think about cochlear
implants.

a. Do they think it will affect their culture?

b. Would they have one if they had the choice?

II. When are people old enough to have an
implant?

a. Do Deaf and hearing people want to give their
children the implant?

Gloria Cosgrove met with
the Metro Silent Club and discussed with them, how they felt about cochlear
implants, since most of the culturally Deaf population thinks that the
implant is trying to "destroy their culture."

"You mentioned medical practice," Gloria
said, "were you thinking about cochlear implants? Where do you stand on
that?"

"It’s a sensitive issue," said Jake, "If
I may speak for most of us, we don’t have a problem with cochlear implants
for adults. But for children who were born Deaf, No! It’s exposing
children to an invasive experimental surgical procedure for dubious
reasons and even more dubious results."

". . . If more and more Deaf children get
cochlear implants and are kept away from the Deaf-WORLD, that would mean
the end of the Deaf culture," Henry said.

"I don’t think that’s going to happen,"
Jake said, "It’s my understanding that though the procedure is very
invasive, an implant is just another kind of hearing aid, a built-in
hearing aid. When hearing aids came into vogue, Deaf culture never faded
away. Instead, we threw away the hearing aids. I think that when these
implanted kids get older, they many get angry at their parents for making
the implant decision for them when they were young. . ."

"But would any of you have one?" Gloria
persisted.

"No!" They were all agreed, though Laurel said
she knew of a few former classmates who were either totally in the hearing
world or marginally in the Deaf, and they would do it. (A Journey into the Deaf-World, Harlen Lane,
Ben Bahan, Robert Hoffmeister, pg. 376)

As this quote states,
all of this club would refuse to have a cochlear implant, one member’s
parents asked her to get a cochlear implant and she didn’t speak with them
for weeks. According to the member her parents hadn’t accepted her for who
she really was. Others state that it would cause the Deaf-World to slowly
dissipate and eventually disappear altogether. Although they did say that
the cochlear implant would probably soon turn out to be just another hearing
aid, a permanent hearing aid, but none the less still a hearing aid.

FDA Requirements for Cochlear Implants:

". . . candidates must be at least two years old
(the age in which specialists can verify the severity of the child’s Deafness). (Living with
Hearing Loss, Carol Turkington, Allen E. Sussman, pg. 100)

As you can see any
Deaf/partially Deaf person can become eligible for an implant once they’ve
reached their second birthday. Many hearing parents apply for this procedure
as soon as their child’s second birthday arrives. The Deaf community
although would leave the child Deaf to join in with the Deaf community.

"It does not seem to matter that the Deaf say
again and again that they value their culture, their language, and their
world. The hearing remain perplexed. This, of course, perplexes the
Deaf-WORLD. The gulf between the two worlds engenders accusations and
recriminations. The Deaf-WORLD is accused of resisting cochlear implants
because it wants to ‘steal’ the Deaf child." (A Journey into the Deaf World, pg. 373)

Unfortunately the more the Deaf try to defend their culture the more the
hearing world try’s to bring it down and create an all hearing world.